| NPI | 1710439237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA066490) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601007915) |
| 363A00000X Physician Assistant (Licence: TX PA12509) | |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2025-10-14 |